Differential Diagnosis for Physical Therapy: Cancer, Hepatic/Biliary, and Renal Disease: Summary 91
○ Venous drainage of most areas of body is through superior and inferior venae cavae ○ Lungs are the first organs to filter malignant cells ○ Mets to lungs can be asymptomatic until tumor cells have reached parietal pleura and pain fibers are stimulated ○ Pleural pain and dyspnea : Usually first two symptoms experienced Hepatic System • Liver mets are most ominous sign of advanced CA ○ Primary met site from stomach, colorectum, and pancreas ○ Symptoms: Abdominal pain, tenderness, malaise, and fatigue Skeletal System • Represents large proportion of initial site of met disease with poor prognosis ○ Usual symptom is bone pain ○ Involvement of vertebrae may cause tetraplegia or paraplegia Early Warning Signs C —changes in bowel/bladder habits A —a sore that does not heal in six weeks U —unusual bleeding or discharge T —thickening/lump in breast or elsewhere I —indigestion or difficulty swallowing O —obvious change in wart/mole N —nagging cough/hoarseness CA Syndrome—Carcinomatous Neuromyopathy Idiopathic proximal muscle weakness, accompanied by diminished deep tendon reflexes (DTR) • Degeneration of motor nerves and denervation
• Signs to look for with moles/marks: ○ A—asymmetry; uneven, lopsided ○ B—border; irregular, poorly defined ○ C—color; black, shades of brown, red, white, or blue ○ D—diameter; larger than pencil eraser ○ E—elevation • Causes: UV exposure; heredity; environment; fair skin ○ One out of seven fair skin individuals in the U.S. gets diagnosed with skin CA ○ One serious sunburn increases chances by 50% Breast Most common site of CA in women (second is lung CA) • Chances of developing breast CA increase with age—mean age is 60 to 61 years • May also affect men ○ Risk factors: Estrogen, postmenopausal obesity, high-fat diet, alcohol intake, familial history, late/no pregnancies, hormonal changes, early menses/late menopause, estrogen replacement therapy • Estrogen: plays a role in stimulating breast cell division and effects other hormones that stimulate breast cell division • Signs/symptoms: Pain and/or itching, palpable lump, nipple discharge, nipples that appear inverted or flattened, swollen lymph nodes under the armpit • HER2 (human epidermal growth factor receptor) signals cells to divide; if positive for CA, testing is done to see number (more than two are seen with aggressive breast CA) ○ One out of three breast CA makes an excess of HER2 due to a gene mutation ○ Herceptin therapy: Antibody that binds selectively to the HER2 protein and no longer causes cells in the breast to reproduce uncontrollably
• Autoimmune Cancer Types Skin
Skin cancer is the most common CA in the U.S. Symptoms include irritation and itching, tenderness/soreness
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